Anterior Cruciate Ligament Rupture
Conditions
Keywords
Anterior cruciate ligament rupture, Preoperative re-education, Knee functional performance, Anterior cruciate ligament surgery, Single-leg hop for distance test performance
Brief summary
Anterior cruciate ligament (ACR) rupture is a common lesion of sportsmen that leads to functional deficits which are difficult to overcome. To prevent from an unfavorable evolution, patients can either get a non-surgical treatment or an ACR surgery, which is very common. Knee functional performance level could impact on the postoperative outcome and it's of common knowledge that early re-education after an ACR rupture improves knee functioning. Patients with an ACR rupture enrolled in this study will be randomized either in an experimental group (with preoperative reeducation) or in a control group (without preoperative reeducation). Both groups will then have post-operative re-education (40 sessions) based on HAS recommendations. The main aim of this study is to assess the impact of preoperative re-education on knee functional performance 4 month after surgical reconstruction of an ACR. Secondary aims are to determine the impact of the 4-week preoperative re-education on knee functional performance after an ACR rupture, before surgery and 7 months after surgery. Functional performance, muscular strength, proprioception and anterior knee laxity will be measured at inclusion (V0), 4-5 days before surgery (V1), 4 month (V4M) and 7 months (V7M) after surgery. Lysholme-Tegner scoring and IKDC2000 questionnaire will be added to the previous assessments.
Detailed description
Anterior cruciate ligament (ACR) rupture is a common lesion of sportsmen that leads to functional deficits which are difficult to overcome. To prevent from an unfavorable evolution, patients can either get a non-surgical treatment or an ACR surgery, which is very common. Knee functional performance level could impact on the postoperative outcome and it's of common knowledge that early re-education after an ACR rupture improves knee functioning. Patients with an ACR rupture enrolled in this study will be randomized either in an experimental group (with preoperative reeducation) or in a control group (without preoperative reeducation). Both groups will then have post-operative re-education (40 sessions) based on HAS recommendations. The main aim of this study is to assess the impact of preoperative re-education on knee functional performance 4 month after surgical reconstruction of an ACR. Secondary aims are to determine the impact of the 4-week preoperative re-education on knee functional performance after an ACR rupture, before surgery and 7 months after surgery. Functional performance, muscular strength, proprioception and anterior knee laxity will be measured at inclusion (V0), 4-5 days before surgery (V1), 4 month (V4M) and 7 months (V7M) after surgery. Lysholme-Tegner scoring and IKDC2000 questionnaire will be added to the previous assessments.
Interventions
BEHAVIORALPreoperative re-education
Preoperative re-education (behavior): 8 re-education sessions of 30 to 40 minutes, 2 times a week, for 4 weeks
Sponsors
University Hospital, Clermont-Ferrand
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Patients between 18 and 45 years old * Tegner physical activity level between 3 and 9 * Primary and unilateral rupture of anterior cruciate ligament, confirmed by MRI * patient available to carry out the preoperative re-education program
Exclusion criteria
* Complex lesion that would impede on preoperative re-education (posterior cruciate ligament, meniscal or chondral symptomatic lesion, fracture)/ * Neurologic or cardiorespiratory pathology contra-indicating preoperative re-education * Previous surgical treatment of the lower limbs or of the lumbar spine * Neuropathic or algodystrophic pain on the lower limbs
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Functional performance as assessed by single-leg hop for distance test performance | at 4 months after ACR surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic balance as assessed by star excursion balance test | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Quadriceps muscular strength as assessed by isokinetic test of quadriceps muscular strength | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Proprioception as assessed by repositioning knee test | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Ability to return to high level athletics as assessed by single-leg hop for distance test performance | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for: | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Subjective knee evaluation as assessed by International Knee Documentation committee 2000 questionnaire | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Knee symptoms as assessed by Lysholme questionnaire | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Physical activity level as assessed by Tegner knee scoring | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
| Knee anterior stability as assessed by KT-1000 | at 4-month follow-up and 7-month follow-up compared to the initial visit and control group for | Assessment for both control and experimental group : inclusion (V0) preoperative visit (V1), 4-month follow-up (V4M) and 7-month follow-up (V7M) |
Countries
France
Contacts
Primary ContactPatrick LACARIN
Outcome results
None listed